xray report

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cdullen
Member

November 11, 2014 at 2:46 am

Post count: 3

#11713

I have Been having lower back and hip pain since high school so like 20 years. After many doctors injections physical therapy and frustrations I think I may have gotten somewhere. About a week ago my new family doctor sent me for xrays. I don’t see him til the beginning of December again so I was wondering if u could help me out with what exactly the report of my xray is saying. I obtained a copy of the report and the exray and this is what it says.

“S1 is a transitional vertebra and is partly lumbarized. The right lateral ala of s1 demonstrates a pseudoarthrosis with s2 with sclerosis.this may be the cause of low back pain.”

Please if you could tell me what this means (in laymen’s terms) I would really appreciate it. Like I said, I don’t see my Dr. For almost a month and I would just finally like to have an answer. My pain is always there. But I have days where I can barely get out of bed. And sometimes require assistance to do so. I cant stand or sit long. If i do i have this crushing pressure in my sacrum and hips. I have had so many different answers as to what is wrong with me that my head is spinning. HELP PLEASE!!! Thank you in advance for your time.

Donald Corenman, MD, DC
Moderator

November 11, 2014 at 9:32 am

Post count: 8660

#11714

A transitional vertebra is a vertebrae that “was confused” when you were an embryo and has taken on the partial appearance of the segment next to it. In your case, the top sacral segment (S1) which normally is fused to the entire sacrum “decided” to be part sacrum and part lumbar vertebra.

Normally, this disorder is not painful as at least one side still is sacralized and is stable enough to be non-movable (non-painful). The sclerosis (whitening noted on X-ray) could be an indication of motion but the chance of this segment being your pain generator is not very high.

X-rays are helpful but used with an MRI are invaluable.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

cdullen
Member

November 11, 2014 at 7:48 pm

Post count: 3

#11719

I feel as though something is causing this. Almost 20 years of pain and im getting worse. All of my pain is located all in my sacrum (more so on the right side) and into my hips. When my sacrum area is troublesome i cannot stand straight, cause when i try to stand straight i get this pinching/catching sensation in my right sacrumhip area that sends me to my knees. The pain also goes across into my right hip socket. Its almost like there is something in there preventing me from being able to do what my body is meant to do and it is extremely painful. I cannot travel for long distances causeit triggers the pain in my sacrum and both hips. It reminds me of the pain i had in my beck when i was in labor with both my children but worse and on a daily basis. I am just at my wits end. This pain has taken over my life. Over the past 10 years I have done physical therapy (twice), on my second chiropractor, pain management, cortasone shots and pain killers and muscle relaxers. Nothing is working!!! I have been out of work for the last 7 years cuz the pain causes me to miss work. Within two hours of being at work i would be in tears from the pain and they would have to send me home cause I couldn’t stand straight to serve customers. Or my husband would have to call me off work cause I couldn’t get out of bed. He would have to help me out of bed and even then i couldnt stand without pain. Pain rubs don’t work either. I can’t take this pain any longer. It keeps me from spending time with my family and they notice this. Its very sad that I have surcumed to my pain. It just keeps getting worse and there isn’t a day that I’m not in some form of pain. Whether it a manageable form or one that puts me down. I wish there was someone who could help me!!!

Donald Corenman, MD, DC
Moderator

November 13, 2014 at 1:02 am

Post count: 8660

#11732

You do have a pain source. This source needs to be diagnosed. The X-rays are a start but you will need a consultation with a spine surgeon and an MRI to continue your diagnostic work-up. Then, diagnostic injections will probably be involved to confirm the diagnosis. You might be a candidate for surgery.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

cdullen
Member

November 13, 2014 at 3:33 am

Post count: 3

#11736

Thank you very much for your professional opinion. I very much so appreciate your help. One last thing. I live in central pennsylvania, close to state college (penn state). I was wondering if you might be able to recommend a few spine surgeons in or close to my area. It would help with going to my doctor for a referral.

Thanks again

Donald Corenman, MD, DC
Moderator

November 13, 2014 at 10:06 pm

Post count: 8660

#11745

At this point, I do not recommend any individuals as I don’t know their surgical abilities. I am planning a ratings system but this is still much “down the road”. Look at the internet for some clues. Understand that internet ratings are not “golden” but might give you some clues about the physician you are going to interview. Also see the section “Questions to ask your spine surgeon” to have some clues to understand their thinking.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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Donald Corenman, MD, DC

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81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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